Working with a team of American researchers, we published in 2014 a review about the association between dental amalgams and chronic disease (1). The following is a summary:

“The purpose of this review is to examine the evidence for a relationship between mercury (Hg) exposure from dental amalgams and certain idiopathic chronic illnesses–chronic fatigue syndrome (CFS), fibromyalgia (FM), depression, anxiety, and suicide. Dental amalgam is a commonly used dental restorative material that contains approximately 50% elemental mercury (Hg0) by weight and releases Hg0 vapor. Studies have shown that chronic Hg exposure from various sources including dental amalgams is associated with numerous health complaints, including fatigue, anxiety, and depression–and these are among the main symptoms that are associated with CFS and FM. In addition, several studies have shown that the removal of amalgams is associated with improvement in these symptoms. Although the issue of amalgam safety is still under debate, the preponderance of evidence suggests that Hg exposure from dental amalgams may cause or contribute to many chronic conditions. Thus, consideration of Hg toxicity may be central to the effective clinical investigation of many chronic illnesses, particularly those involving fatigue and depression.”

Norway and Sweden have banned amalgam, reportedly due to environmental concerns. However, the use and toxic risk of dental amalgam fillings is still a subject of ongoing debate in many countries. Now, a review conducted by a team of international researchers has provided new evidence that mercury exposure from dental amalgam may cause or contribute to many chronic illnesses, as well as depression, anxiety and suicide.

The purpose of this review is to examine the evidence for a relationship between mercury (Hg) exposure from dental amalgams and certain idiopathic chronic illnesses – chronic fatigue syndrome (CFS), fibromyalgia (FM), depression, anxiety, and suicide. Dental amalgam is a commonly used dental restorative material that contains approximately 50% elemental mercury (Hg0) by weight and releases Hg0 vapor. Studies have shown that chronic Hg exposure from various sources including dental amalgams is associated with numerous health complaints, including fatigue, anxiety, and depression – and these are among the main symptoms that are associated with CFS and FM. In addition, several studies have shown that the removal of amalgams is associated with improvement in these symptoms. Although the issue of amalgam safety is still under debate, the preponderance of evidence suggests that Hg exposure from dental amalgams may cause or contribute to many chronic conditions. Thus, consideration of Hg toxicity may be central to the effective clinical investigation of many chronic illnesses, particularly those involving fatigue and depression.

Copper amalgams, consisting 60-70% mercury (Hg) and 30-40% copper (Cu) (1, 2), were used very commonly in Norway for children with caries – allegedly because they were thought to inhibit the development of new caries. But they were used in a way making them far more dangerous for dental health personnel than other types of amalgam because the amalgam powder was heated in a metal spoon in a gas flame until Hg droplets could be observed (Fig 1). In poorly ventilated rooms, this gave an enormous Hg exposure by inhalation to the dental health personnel, but even more to the dental assistants than to the dentists.

The average levels of occupational exposure to Hg among dental health personnel was earlier very high, at least in the Scandinavian countries including Norway, and in some cases (not very infrequently) excessively high (3, 4), especially in public dental health clinics with large numbers of schoolchildren as patients, where copper amalgam was used as a matter of routine to make fillings for the children because of its assumed cariostatic effect. A medical student at the University of Oslo made a student thesis, where he studied the Hg concentration in the air in dental health clinics, and in some of them found excessively high levels far exceeding (by more than a factor of 10) what was at that time the maximal permitted levels of exposure (3). This student thesis was carried out under supervision of his older brother, who was working in a leading position at the Norwegian Institute of Occupational Health. But the older brother, who had been the supervisor, did never inform the Directorate of Occupational Health about his younger brother’s observations, as nevertheless had been his duty (because of his job in a leading position at the institute) to do (Olav Albert Christophersen, personal communication).

The late Dr. Hans Tjønn, who at that time was chief doctor at the Institute of Occupational Health, had suspected that the conditions at Norwegian dental health clinics were not satisfactory from the point of view of occupational hygiene, and had taken up this question in meetings both with the Norwegian Directorate of Health and professors at the Faculty of Dentistry at the University of Oslo (Olav Albert Christophersen, personal communication). But he had been assured both by the people in the Norwegian Directorate of Health and the professors at the Faculty of Dentistry that everything was O.K., and that there was no need for him to be worried (Olav Albert Christophersen, personal communication). If he had been informed about the findings of Jon Norseth, he would have had the evidence he needed to tell the people in the Norwegian Directorate of Health that their assumptions about good occupational health conditions in the Norwegian dental health clinics were far from correct (Olav Albert Christophersen, personal communication). And the Norwegian Directorate of Occupational Health had the necessary legal mandate in Norwegian law (Arbeidsmiljøloven) that it would not have been necessary for them to ask the Directorate of Health for permission in order to stop the problems. If that, historically counterfactually, had happened, several hundred Norwegian dental health assistants and dentists might have been spared for sometimes severe health problems caused by Hg poisoning, and also because of poisoning by some of those organic toxic substances that have been much used in dental health clinics, such as chloroform and hydroquinone.

This is a lecture by the German medical doctor Joachim Mutter about dental amalgam and nanotechnology. It was held at the 4th Anti-Censorship-Conference (Anti-Zensur-Koalition) – 27. Juni 2009 in Widnau, Schweiz. Dr. Mutter is a CONEM-member.

The Minamata Convention on Mercury is a global, legally binding treaty which opened for signature on October 10, 2013 in Japan. To address the global oral health and environmental impact of mercury dental amalgam fillings, first author Tim K. Mackey and co-authors John T. Contreras and Bryan A. Liang collaborated on a peer-reviewed scientific journal article entitled The Minamata Convention on Mercury: Attempting to address the global controversy of dental amalgam use and mercury waste disposal published by Elsevier in Scienceof the Total Environment (1). The article gives an introduction to the international debate regarding mercury use in dental amalgam, examines the unresolved global dental amalgam controversy from an environmental and dental professional society perspective, describes the Convention’s provisions to phase-down the use of dental amalgam, and proposes a tiered programmatic policy approach to strengthen the implementation phase of the Convention.

On behalf of the United States of America, the Assistant Secretary of State for Oceans and International Environmental and Scientific Affairs simultaneously signed and ratified the Convention on November 6, 2013. The nation’s quick ratification of the treaty reflects the belief that the country can implement treaty-bound obligations under existing legislative and regulatory authority. To offer their opinion on the clinical dentist’s amalgam governance leadership role in America, first author John T. Contreras and co-authors Tim K. Mackey and Bryan A. Liang collaborated on a viewpoint article entitled Global Amalgam Governance: The Need for Clinician Leadership – Grassroots education and action from dentists are needed next steps, published by AEGIS Communications in Inside Dentistry (2). The article addresses the following matters of concern: the treaty’s permissive language regarding mercury amalgam use and disposal; mercury vapor exposure to patients and dental workers; mercury amalgam waste contamination of the environment; the dental clinician’s role as a leading stakeholder in choosing to continue, phasedown, or phaseout use of amalgam; and the dental professional’s ethical and legal duties to society. According to the authors, the future of global oral health and protection of the environment likely depends on clinical dentists’ leadership. John T. Contreras, D.D.S. is a CONEM member.

Vera Stejskal, Ph.D. is Associate Professor of Immunology at University of Stockholm, Sweden. She is founder and preident of the MELISA® MEDICA Foundation, which is dedicated to the science of metal allergy and its diagnosis when treating chronic diseases such as chronic fatigue syndrome/myalgic encephalopathy (CFS /ME), multiple sclerosis (MS) or other autoimmune and allergic diseases. She is also a CONEM member.

The MELISA® test, invented by Dr. Stejskal, is the only scientifically-proven blood test which diagnoses metal allergy to multiple metals. Further test applications include the diagnosis of Lyme disease. In this lecture, Vera Stejskal talks about MELISA® testing to diagnose and treat metal-induced diseases and conditions. The lecture was held in September 2008 at IAOMT Annual Meeting in Charlotte, North Carolina.

This is an abbreviated version of “Quecksilber: The Strange Story of Dental Amalgam”, a documentary produced by Robert Gammal, BDS. It was made for the lay person but is fully referenced, and appropriate for persons at all levels of knowledge. The documentary shows, visually and informatively, how no amount of mercury is safe in the body. Dr. Gammal is a CONEM member.

This is an open letter from Robert Gammal, BDS (July 2011): “Dental students are the only students who are routinely poisoned by mercury, the third most toxic, non-radioactive substance known, without their knowledge or consent. Only arsenic and lead are more toxic than mercury. The consequences are horrific.” Dr. Gammal is secretary of the Australian Society of Oral Medicine and Toxicology (ASOMAT), and a CONEM member. Read The Letter